Patient understanding of the revised USPSTF screening mammogram guidelines: need for development of patient decision aids

Patients from the Departments of Family Medicine, Internal Medicine, and Obstetrics and Gynecology (n = 150) at a tertiary care medical center in the United States completed a survey regarding their understanding of the revised USPSTF guidelines following their release, within four to six months of their scheduled mammogram (March 2010 to May 2010).Of the patients surveyed, 97/147 (67%) indicated increased confusion regarding the age and frequency of screening mammography, 61/148 (41%) reported increased anxiety about mammograms, and 58/146 (40%) reported anxiety about their own health status following the release of the revised screening guidelines. Most of the patients surveyed, 111/148 (75%), did not expect to change their timing or frequency of screening mammograms in the future.Results from this survey suggested increased confusion and possibly an increase in patients’ anxiety related to screening mammography and their own health status following the release of the revised USPSTF screening mammogram guidelines to the public and subsequent media portrayal of the revised guidelines. Although the study did not specifically address causality for these findings, the results highlight the need for improvements in the communication of guidelines to patients and the public. Development of shared decision-making tools and outcomes should be considered to address the communication challenge.Breast cancer is the second most common cause of cancer mortality among women in the United States [1,2]. Screening mammography has been an important tool in early detection of breast cancer, resulting in a decrease in breast cancer mortality [3,4]. In November 2009, the United States Preventive Services Task Force (USPSTF), an independent panel of experts in prevention and primary care, released a revision of the screening mammogram guidelines pertaining to the age at which to initiate mammography and the frequency of screening mammography. The guidelines had last been updated in 200